Case 261 -- A Left Thyroid Mass

Contributed by Raj Hari, MD Published on line in March 2001

PATIENT HISTORY:

The patient is a 66-year-old gentleman who presented with a left thyroid mass. The patient was evaluated at an outside facility, and a fine needle aspirate was done which revealed suspicious cells for papillary carcinoma. The patient had a palpable prominent left thyroid area mass but also had prominent lymphadenopathy. The patient underwent an MRI scan which indeed revealed a large thyroid mass. In addition, there was a large zone II mass which was compressing the internal jugular vein. There also appeared to be lymphadenopathy in the jugular chain in zones III and IV.

GROSS DESCRIPTION:

The specimen was received fresh, appropriately identified and was labeled "left thyroid lobe". The specimen consisted of thyroid weighing 42.34 grams and measuring 6.1 x 5.2 x 2.0 cm. The specimen is unoriented, no suture or stitch is noted. The external surface appears shiny, gray-maroon with attached perithyroidal fat. There is no evidence of gross extension of tumor outside the thyroid capsule. On cut section, there is a 4.5 cm poorly circumscribed, tan-white, indurated lesion with infiltrating borders and foci of hemorrhage and necrosis. The rest of the thyroid is orange-yellow, fleshy with no evidence of nodules noted. The external surface was inked in black.